There is substantial interpatient variability in response to many medications used to treat cardiovascular disease. This variability has led many to believe that genetic variation may be affecting response to cardiovascular drugs. The effect of genetics on response to β -blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), diuretics, statins, ezetimibe, warfarin, aspirin, and clopidogrel has been well studied. This article will review, by drug class, some of the more promising lines of research in cardiovascular pharmacogenomics, some of which have already left the bench and moved to the bedside. Perhaps the best example of pharmacogenomics transitioning from the bench to the bedside is CYP2C9 and VKORC1 genotyping with warfarin. The focus in cardiovascular pharmacogenomics is switching from smaller gene association studies to genetic analyses from large, controlled clinical trials. However, before clinical pharmacogenomic testing can be used in cardiovascular medicine, prospective pharmacogenomic data will be necessary.
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